You must fully understand the risks and requirements for taking medications

You must be committed to actively participating in the rehab process after transplant

You must not have smoked or used alcohol for at least 3 months before being put on the transplant waiting list, and you must be trusted not to smoke or drink afterward

You cannot be overweight

You must not have dental work in progress

Your health insurance must verify that your heart transplant costs will be covered!

How does a donor heart get to me?

A potential donor who has been confirmed brain dead must be identified

Next of kin is told of the chance to donate their relative's organs and tissues. They must give their permission

An OPO - Organ Procurement Organization - is called to decide if any of the donor's organs are acceptable. If so, they get the family's official permission and attempt to match the donor with the most suitable recipient(s)

Organs are surgically removed from the donor

The donor organs are taken to the transplant center where the surgery will be done

That's where you come in as the potential recipient

How are people matched to donor organs?

People waiting for a heart in the USA are listed on a national waiting list of potential recipients. They are listed at the transplant center where they plan to have surgery. UNOS - United Network for Organ Sharing - maintains the national waiting list in Richmond, Virginia. They are under contract to do this with the federal Health Resources and Services Administration. UNOS operates the OPTA - Organ Procurement and Transplantation Network - and maintains a 24 hour a day telephone service to help match donor organs with patients on the waiting list.
When a donor organ becomes available, several factors are considered to make a "match." Medical compatibility of the donor and recipient in:HLA match (although this plays only a minor role when the organ is a heart), blood type, weight, age, and urgency of need.
For heart transplants, geography can be important. Unlike other organs, a donor heart stays usable for no more than 6 hours outside the body. This makes a precise match impossible. Livers last up to 24 hours and kidneys up to 72 hours so they can be better matched to the recipient than a heart.

How much does all this cost?

Average transplant costs vary a great deal from person to person and from area to area. Complications after surgery, how severe your rejection episodes are, length of hospital stays, and differences in hospital costs also vary greatly. The approximate range and average are: (cost listed in USA dollars)

Transplant expense

Organ

Cost Range

Average Cost

Heart

$50,000 - $287,000

$148,000

Kidney

$25,000 - $130,000

$51,000

Liver

$66,000 - $367,000

$235,000

Pancreas

$51,000 - $135,000

$70,000

Heart/Lung

$135,000 - $250,000

$210,000

Source: Battelle Institute/Seattle Research Center

Most transplants are paid for by private health insurance, although the Medicare and Medicaid programs pay for certain transplants for certain people. Many private insurers now cover heart transplants. However, you must contact your insurance company to know if you are covered and for how much. Some insurances cover you for less if you have the procedure done at a hospital outside their "system." This is the case for me.
Your heart transplant costs might be reimbursed by Medicare if you are Medicare eligible and the transplant is done at a Medicare approved center. Medicaid coverage for your transplant is decided by your state's State Medicaid program. If your state does cover your procedure, the federal government will provide funds on a matching basis.
Although legislation to change this is in the works, currently your meds are only covered by Medicare for the first 3 years, and then you are on your own!

Material taken from manuals given to potential transplant recipients at USA transplant centers, and from the Virtual Hospital - Updated January 13, 2004